Data processing: financial – business practice – management – or co – Automated electrical financial or business practice or... – Insurance
Reexamination Certificate
1999-08-12
2010-10-12
Morgan, Robert W (Department: 3626)
Data processing: financial, business practice, management, or co
Automated electrical financial or business practice or...
Insurance
C705S002000, C705S003000
Reexamination Certificate
active
07813944
ABSTRACT:
Detection of insurance premium fraud is provided by a predictive model, which uses derived variables to assess the likelihood of fraud for each policy. The predictive model produces a score, which is a measure of the likelihood of premium fraud or abuse. The predictive model is included in a system that accepts policies to be considered for scoring, selects which policies are appropriate for scoring, stores data about the policies in a database, uses the data to derive variables for the model, and processes and outputs the model scores and related information. A rule-based analysis, which detects specific inconsistencies in the data that are indicative of premium fraud, may also be part of the system. The model scores and red-flag indicators from the rule-based analysis may be further processed to provide customized output for users.
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Brochure: Insurance Solutions, Vericomp Claimant.Claimant Fraud and Abuse Detection for Workers' Compensation, HNC Software.
Coates Pamela E.
Deo Arati S.
Downs Sean M.
Friesen Benjamin A.
Luk Ho Ming
Fair Isaac Corporation
Mintz Levin Cohn Ferris Glovsky and Popeo P.C.
Morgan Robert W
LandOfFree
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